Lumbar discopathy is the slow and progressive deterioration of the intervertebral discs, these little “cushions” acting as shock absorbers. When do we talk about L4-L5 and L5-S1 disc disease? How to relieve lumbar disc disease? Can it be cured or slowed down?
What is lumbar discopathy?
Lumbar disc disease is a progressive wear of the intervertebral discs. We can imagine”the intervertebral disc like a car tire“, explains Dr. Amélie Léglise, orthopedic surgeon in Bordeaux.It is a shock absorber between the vertebrae. With time, it deflates and dehydrates, then occurs lumbar discopathy. It’s not really a disease, but the result of normal aging of the back. In some people, disc disease begins earlier, due to genetic share“. This condition is very common, since it affects most of the population with age.
What is staged lumbar disc disease?
Staged disc disease affects several levels of the spine. The inside of each intervertebral disc is made of a gel called “nucleus pulposus“. With the years, the discs become dehydrated. This dehydration will cause a micro-tear or a crack in the disc, causing the vertebrae to come together. Therefore, lesions and dysfunctions joint on several floors of the column will be created.
What is L4-L5 lumbar disc disease?
The lumbar vertebrae are 5 in number and are numbered from L1 to L5. These bones are found at the bottom of the spine, below the thoracic vertebrae, just above the pelvis. Solid, they allow the body to make movements of flexion and extension. We talk about L4-L5 lumbar discopathy when the degeneration affects the disc located between the L4 lumbar vertebra and the L5 lumbar vertebra.
What is L5-S1 lumbar disc disease?
When disc disease affects the last L5 lumbar disc and first S1 sacral vertebra, we speak of L5-S1 discopathy. This area of the spine is frequently affected because “She has a pivotal role. The L5-S1 area includes a stable surface and a mobile surfacewhich wears out faster“, specifies Marion Glowacz, liberal masseuse-physiotherapist.
What are the symptoms of lumbar disc disease?
The main symptom of lumbar disc disease ishas pain, which can be mild to severe. A patient can suffer from acute pain without significant structural damage. In other cases, the wear is at a more advanced stage, while the patient does not feel any sharp pain. When a sciatic nerve is pinched, the pain may radiate to the buttocks and thighs. Sometimes the pain spreads to the neck (cervicalgia) or to the upper back (dorsalgia).
“The secret is to move“, confesses Dr. Léglise. “We don’t really advocate rest anymore. Today, you have to move as much as possible and stretch to reduce pressure on the vertebrae and pain. The more the deep muscles of the back are strengthened, toned and reactive, the more they absorb the mechanical stresses and the more the degeneration is slowed down. pilates and yoga have a definite interest in curbing lumbar disc disease“, details the orthopedic surgeon. “Heat and muscle relaxation relieve the pain of lumbar disc disease, as do certain postures, such as the posture of the child in yoga or the fetal posture, in which we position ourselves on the side and we bring both knees to the chest, in gun dog“, completes the physiotherapist. “The joints of the vertebrae can be likened to a cogwheel that slides”. illustrates Dr. Léglise. “When the disc becomes dehydrated, it absorbs shocks less well: the joints overheat in response to their overwork and this is when the acute pain occurs.“. It is then possible to prescribe anti-inflammatory treatment, unless contraindications exist. As for the infiltration in case of lumbar discopathy, it intervenes “at the beginning stage and in the acute phase, to lubricate the joint in order to unlock it and make it slide a little better“, explains Dr. Léglise.
Lumbar disc disease operation: indications, principles
Several stages exist. “It is important to take stock with your doctor, but also to perform an MRI to classify the stage of lumbar disc disease“, advises Dr. Léglise.”When it is at a very advanced stage or the patient no longer has a disc, we imagine that we are rolling on the rim. We then consider arthrodesis surgery, which involves fusing the joint by placing a wedge filled with synthetic bones in place of the disc“, details the surgeon. “Another type of surgery exists, more complex, in which we let’s replace the worn disc with an artificial disc”.
What exercises to do if you have lumbar disc disease?
“The exercises to do in case of lumbar discopathy are exercises muscle building“, says Marion Glowacz, physiotherapist. “The more the back is muscular and sheathedthe more the joints are protected, which generates less stress on the intervertebral discs“. We favor “extension postures in case of herniated disc, to relieve and decompress the discs. Stretching the muscles of the lower limbs, hamstrings, gluteal and quadriceps pyramids help relieve pain in lumbar disc disease”.
What is the role of the physiotherapist in the management of lumbar discopathy?
The place of the physiotherapist is essential, in particular to slow the progression of discopathy. “Everyone should go to their physiotherapist, even before the onset of pain in order to know the right postures to preserve your back“, says Dr. Léglise. Indeed, the role of the physiotherapist is to “give the right gestures of muscle strengthening to avoid pain. To reduce inflammatory pain, heat and massage are effective techniques in physiotherapy“, explains Mrs. Glowacz. “Ideally, the patient is advised to do a suitable sport to maintain, but also to take stock once or twice a year with his physiotherapist”. After back surgery, “physiotherapy sessions help with rehabilitation”, adds the orthopedic surgeon.
How much downtime when you have lumbar disc disease?
The downtime after lumbar discopathy is very variable depending on the case and the profession of the patient. “EIt varies from 48 hours to 3 weeks, depending on muscles, recovery capacities and profession of the patient”, emphasizes Dr. Léglise. Often, the duration of the work stoppage continues until the decrease in inflammation and pain.
Thank you to Doctor Amélie Léglise, orthopedic surgeon in Bordeaux and to Marion Glowacz, liberal masseuse-physiotherapist.
Sources:
– Replacement of the lumbar intervertebral disc by prosthesis, February 12, 2004, HAS
– Lumbago or back pain, what are we talking about? October 20, 2022, Ameli